Individual provider Active NPI

Victoria A McElligott, LCSWR

  • Clinical Social Worker
  • Norwich, NY
National Provider Identifier
1508924531
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R046000-1 Issued in NY
Practice address
105 Leilanis LN
Norwich, NY 13815-3540
Phone
(607) 337-1680
Fax
(607) 336-1380
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R046000-1 NY
Clinical Social Worker 1041C0700X R046000-1 NY Primary

Addresses

Primary practice location

105 Leilanis LN
Norwich, NY 13815-3540

Mailing address

1965 County Route 35
Mount Upton, NY 13815
Phone (607) 337-1680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110817000705 NY Practitioner - Clinical Social Worker 7719156249 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R046000-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Nov 3, 2014 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Nov 3, 2014 Accepting new patients
County of Chenango Past Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1508924531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 COUNTY ROUTE 35",
            "city": "MOUNT UPTON",
            "state": "NY",
            "postal_code": "13815",
            "telephone_number": "607-337-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 LEILANIS LN",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "138153540",
            "telephone_number": "607-337-1680",
            "fax_number": "607-336-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCELLIGOTT",
        "first_name": "VICTORIA",
        "middle_name": "A",
        "credential": "LCSWR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "R046000-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R046000-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, NY

Sources for this page

Verify at the official NPI Registry.